CPT 27485 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 50 - Bilateral Procedure • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 27485 by major payers:
$909.33
$907.42
$953.79
$1,131.86
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 27485 | ||||||
United | 27485 | $750.00 | 1710952882 - ADVANCED DERMATOLOGY AND SKIN SURGERY, PLLC | 813253496 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $3500.00 | 1881013142 - ADVANCED SURGERY CENTER OF TAMPA, LLC | 463891843 - (FL) ADVANCED SURGERY CENTER OF TAMPA, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $410.00 | 1255311635 - MELBOURNE ASC LP, THE SURGERY CENTER OF MELBOURNE | 621625311 - (FL) MELBOURNE ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $1229.00 | 1215429030 - MEDICAL AND DENTAL CENTER OF NEVADA LLC | 825250965 - (NV) MEDICAL AND DENTAL CENTER OF NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $2403.00 | 1124125331 - AMBULATORY SURGERY ASSOCIATES, LLC, BROOKSIDE SURGERY CENTER | 383237596 - (MI) AMBULATORY SURGERY ASSOCIATES | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $3705.00 | 1437202249 - PACMED CLINICS | 562290878 - (WA) PACMED CLINICS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $2799.00 | 1023604931 - ADVANCED SPINE AND PAIN SURGERY CENTERS LLC | 854282481 - (AZ) ADVANCED SPINE AND PAIN SURGERY CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $515.00 | 1760778765 - GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK, LLC, TOWN LAKE ENDOSCOPY CENTER | 274193796 - (GA) GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $2640.00 | 1538736459 - PONY CREEK ANNEX, LLC | 844833158 - (OR) PONY CREEK ANNEX LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $2500.00 | 1154959179 - MUNSTER SURGERY CENTER LLC | 844828519 - (IN) MUNSTER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $2814.00 | 1134785389 - CEI PHYSICIANS PSC, LLC, CVP SURGERY CENTER | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $6285.00 | 1306163431 - ROC SURGERY LLC, RILEY OUTPATIENT SURGERY CENTER | 271497960 - (IN) ROC SURGERY LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $1142.00 | 1205925278 - LUDWICK LASER & SURGERY CENTER, LLC | 205159711 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $1360.00 | 1063416998 - WILMINGTON SURGERY CENTER, LP, WILMINGTON SURGCARE | 621775670 - (NC) WILMINGTON SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27485 | $7264.00 | 1174588099 - IU HEALTH ARNETT HOSPITAL, INC, ARNETT SURGERY CENTER, LLC | 263162145 - (IN) INDIANA UNIVERSITY HEALTH ARNETT INC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 27485 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27485 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 27485 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 27457-CPT | High | Osteotomy, Proximal Tibia, Including Fibular Excision Or Osteotomy (Includes Correction Of Genu Varus (Bowleg) Or Genu Valgus (Knock-Knee)); After Epiphyseal Closure |
| 27479-CPT | High | Epiphy.Arrest;Comb.D.Femur,Prox T/F |
| 27485-CPT | Moderate | Arrest Hemiepiphyseal Leg Proximal |
| 27503-CPT | High | Closed Treatment Of Supracondylar Or Transcondylar Femoral Fracture With Or Without Intercondylar Extension, With Manipulation, With Or Without Skin Or Skeletal Traction |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27485. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27485 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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